Validating the GDS Depression Screen in the Nursing Home

McGivney, Shawn A.; Mulvihill, Michael; Taylor, Brian

doi:10.1111/j.1532-5415.1994.tb04969.x

Cited by 194 publications

(127 citation statements)

References 20 publications

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“…For the second component ("exhaustion"), we included only the demented patients with a MMSE score ≥15 because the use of the GDS has been validated within this MMSE score limit (Table 1; Mcgivney et al 1996). We excluded at baseline both for the outcome all-cause mortality and the outcome disability older subjects with severe sensorial deficit, bedridden or in wheelchairs, dizziness, severe osteoarthritis, a history of Parkinson's disease, stroke, dementia, or MMSE score <15, as these conditions could potentially constitute frailty components as a consequence of a single disease (Fig.…”

Section: Methodsmentioning

confidence: 99%

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Solfrizzi

Scafato

Frisardi

et al. 2011

AGE

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Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on allcause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65-84 years old. Participants received identical baseline evaluation at the 1st survey (1992)(1993) and were followed at 2nd (1995)(1996) and 3rd survey (2000)(2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this populationbased study was 7.6% (95% confidence interval (CI) 6.55-8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the cooccurrence among these conditions. Frailty was associated with a significantly increased risk of allcause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52-2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44-2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06-1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88-1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3-(HR 3.33, 95% CI 1.28-8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10-3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short-and long-term predictor of all-cause mortality in nondemented and demented patients.

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Section: Methodsmentioning

confidence: 99%

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Solfrizzi

Scafato

Frisardi

et al. 2011

AGE

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“…Although it performs well in patients with mild to moderate cognitive impairment, [152][153][154] the data on its validity in moderate to severely cognitively impaired patients are conflicting. 153,[155][156][157][158] The GDS is in the public domain (see, for example, Table 3) and has been translated in many European and Asian languages.…”

Section: Geriatric Depression Scale (Gds) Depression In Non-pd Patientsmentioning

confidence: 99%

Depression rating scales in Parkinson's disease: Critique and recommendations

Schrag¹,

Barone²,

Brown³

et al. 2007

Movement Disorders

584

348

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Depression is a common comorbid condition in Parkinson's disease (PD) and a major contributor to poor quality of life and disability. However, depression can be difficult to assess in patients with PD due to overlapping symptoms and difficulties in the assessment of depression in cognitively impaired patients. As several rating scales have been used to assess depression in PD (dPD), the Movement Disorder Society commissioned a task force to assess their clinimetric properties and make clinical recommendations regarding their use. A systematic literature review was conducted to explore the use of depression scales in PD and determine which scales should be selected for this review. The scales reviewed were the Beck Depression Inventory (BDI), Hamilton Depression Scale (Ham-D), Hospital Anxiety and Depression Scale (HADS), Zung Self-Rating Depression Scale (SDS), Geriatric Depression Scale (GDS), Montgomery-Asberg Depression Rating Scale (MADRS), Unified Parkinson's Disease Rating Scale (UPDRS) Part I, Cornell Scale for the Assessment of Depression in Dementia (CSDD), and the Center for Epidemiologic Studies Depression Scale (CES-D). Seven clinical researchers with clinical and research experience in the assessment of dPD were assigned to review the scales using a structured format. The most appropriate scale is dependent on the clinical or research goal. However, observer-rated scales are preferred if the study or clinical situation permits. For screening purposes, the HAM-D, BDI, HADS, MADRS, and GDS are valid in dPD. The CES-D and CSDD are alternative instruments that need validation in dPD. For measurement of severity of depressive symptoms, the Ham-D, MADRS, BDI, and SDS scales are recommended. Further studies are needed to validate the CSDD, which could be particularly useful for the assessment of severity of dPD in patients with comorbid dementia. To account for overlapping motor and nonmotor symptoms of depression, adjusted instrument cutoff scores may be needed for dPD, and scales to assess severity of motor symptoms (e.g., UPDRS) should also be included to help adjust for confounding factors. The HADS and the GDS include limited motor symptom assessment and may, therefore, be most useful in rating depression severity across a range of PD severity; however, these scales appear insensitive in severe depression. The complex and time-consuming task of developing a new scale to measure depression specifically for patients with PD is currently not warranted.

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“…Patients with an MMSE < 15 were excluded for this paper as the GDS loses validity below this threshold (McGivney et al, 1994).…”

Section: Sample and Proceduresmentioning

confidence: 99%

“…Yesavage et al (1983) introduced the Geriatric Depression Scale, a self-rating, 30 item questionnaire that was especially developed for the elderly, without focusing on physical complaints. This instrument has been found to be reliable and valid in multiple settings, including nursing homes (Yesavage et al, 1983;Lesher, 1986;D'Ath et al, 1994;Gerety et al, 1994;McGivney et al, 1994). On the other hand, it has also been found less feasible for the nursing home setting (Wagenaar et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Construction and validation of a patient‐ and user‐friendly nursing home version of the Geriatric Depression Scale

Jongenelis

Gerritsen

Pot

et al. 2007

Int J Geriat Psychiatry

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SUMMARYObjective To construct a patient-and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. Methods The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n ¼ 410), the Mini Mental State Examination (n ¼ 410) and a diagnostic interview (SCAN; n ¼ 333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, items that were identified as unsuitable were removed using the data of the Assess project (n ¼ 77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specitivity, area under ROC and positive and negative predictive values), the newly constructed shortened GDS was validated in the AGED data set (n ¼ 333), using DSM-IV diagnosis for depression as measured by the SCAN as 'gold standard'. Results The eight-item GDS that resulted from stage 1 showed good internal consistency in both the Assess data set (a ¼ 0.86) and the AGED dataset (a ¼ 0.80). In the AGED dataset, high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. Conclusion The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population.

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Validating the GDS Depression Screen in the Nursing Home

Abstract: The two-step procedure of first selecting those with MMSE scores > or = 15 and then giving the GDS significantly increases the utility of the GDS in detecting depression in NH residents and should improve the diagnostic process for this widely underdetected problem.

Cited by 194 publications

References 20 publications

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Depression rating scales in Parkinson's disease: Critique and recommendations

Construction and validation of a patient‐ and user‐friendly nursing home version of the Geriatric Depression Scale

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